scholarly journals Delays on Treatment and Associated Factors in a Cohort of Women Diagnosed With Breast Cancer in Rio De Janeiro, Brazil

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 60s-60s
Author(s):  
I.F.d. Silva ◽  
S.D.O. Monteiro ◽  
R.J. Koifman
Keyword(s):  
Breast Cancer ◽  
Developing Countries ◽  
Late Stage ◽  
College Education ◽  
Treatment Delay ◽  
Medical Attention ◽  
Time Interval ◽  
Histopathological Diagnosis ◽  
Stage At Diagnosis ◽  
Negatively Associated

Background: The majority of breast cancer death occurs in developing countries. Mortality reductions achieved in the last decades in developed countries have not been reached in developing countries mainly because of a lack of access to early medical attention and delays on treatment. There are very few research studies on the reasons behind delayed medical attention for breast cancer in women in developing countries. Aim: To estimate the treatment delay, and associated factors, among women diagnosed with breast cancer treated on the National Cancer Institute in Rio de Janeiro, Brazil. Methods: A retrospective study on a cohort of 3220 women newly diagnosed with breast cancer between 2011 and 2013 was accomplished. Times from diagnose to treatment initiation were analyzed according to the Brazilian law for cancer patient treatment (≤ 60 > days). Association between sociodemographic, life style, clinical and treatment variables, and delays on treatment were estimated using X2-test and logistic regression model, with 95% confidential interval. Results: Over 50% of women was 50-69 years old, white (50.5%), presented early stage at diagnosis (63.8%), and refereed from public health service (76.9%). From those who had a histopathological diagnosis on the first visit at NCI (N=2,554), median time from diagnose to 1st treatment was 108 days, varying from 97 days (stage T0-2N>1-X/T3-4N0/X) to 133 days (stage Tis). Among those, prevalence of treatment delay was 89.1%; time interval > 30 days from diagnosis and 1st visit at NCI (OR=29.84; CI: 19.80-44.97) and age (50-69: OR=1.61; CI: 1.24-2.11, ≥70 years: OR=1.91; CI: 1.27-2.89) were statistically associated with treatment delay; while high education (OR=0.31; CI: 0.13-0.73) and late stage at diagnosis (OR=0.63; CI: 0.49-0.80) were negatively associate with treatment delay. Among those who arrived without diagnosis (n=666), prevalence of treatment delay was 34.7%. Considering the whole cohort (N=3220) age ≥70 years old (OR=1.42; 1.04-1.94), living outside Rio city (OR=1.53; 1.26-1.87), and chemotherapy (OR=1.44; 1.06-1.95) were positively associated with delay; while college education (OR=0.73; 0.57-0.94) and late stage (OR=0.71; 0.53-0.96) were negatively associated with treatment delay. Conclusion: Increased breast cancer treatment delay was observed among women who arrived with histopathological diagnosis. Time interval from diagnosis on the 1st visit at cancer center was the main factor associated to treatment delay, followed by old age; while high education level and late stage at diagnosis were negatively associated with treatment delays. Considering the whole cohort, old age, living outside Rio and chemotherapy were positively associated to delays on treatment, while college education level and late stage were negatively associated with treatment delay.

scholarly journals Delays on Breast Cancer Treatment in Brazil: Implications on Survival

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 64s-64s
Author(s):  
I.F.d. Silva ◽  
S.D.O. Monteiro ◽  
R.J. Koifman
Keyword(s):  
Breast Cancer ◽  
Median Time ◽  
Late Stage ◽  
Treatment Initiation ◽  
Cox Regression ◽  
Survival Rates ◽  
Treatment Delay ◽  
Time Interval ◽  
Death Risk

Background: Breast cancer survival may vary among regions in Brazil, being lower in northern and northeastern than in southern and southeastern regions. Earlier studies in developed countries have suggested that increased time intervals of care are associated with poorer chances for survival. There is a lack of studies on developing countries about the effect of time interval on survival. Aim: To estimate the effect of treatment delay on 3- and 5-years survival among women diagnosed with breast cancer treated on the National Cancer Institute in Rio de Janeiro, Brazil. Methods: A retrospective study on a cohort of 3220 women newly diagnosed with breast cancer between 2011 and 2013 was accomplished. Follow-up time was 60 months for women diagnosed in 2011-2012 (n=836), and 36 months for the whole cohort. Times from diagnose to treatment initiation were analyzed according to the Brazilian law for cancer patient treatment (< 60 > days). All data were obtained from hospital-based cancer registry and medical reports. Estimates of 3- and 5-survival were proceeded by Kaplan-Meier method. Survival curves differences were evaluated by 95% log-rank test. Crude and adjusted hazard ratios between delay on treatment initiation, age, education, stage and 1st treatment and death risk were estimated by proportional Cox regression with respective 95% confidential interval. Results: Mean time follow-up in the 2011-2012 cohort was 55.3 (± 12.7) months with median time of 60 months; while in the whole cohort mean follow-up time was 34.1 (± 6.1) months with 36 months of median time. Concerning the treatment delay, 3-years survival rates were 88.7% among women with ≤ 60 days for treatment initiation and 88% among women with delay on treatment (log-rank: 0.786); while 5-years survival rates were 85.2% among women with ≤ 60 days to treatment and 82.5% for women with delays on treatment (log-rank: 0.373). Delay on treatment (OR=0.77; 95 CI: 0.61-0.97), age ≥ 70 years old (OR=2.03; 95% CI: 1.46-2.82), late stage at diagnosis (OR=7.48; 95% CI: 2.27-24.61), and 1st treatment (ORCHEMO=2.66; 95% CI: 1.82-3.90; ORRADIATION/HORMONE=2.53; 95% CI: 1.58-4.06) were independently associated with death risk in 3 years. Death risk in 5 years is independently associated to age ≥ 70 years (OR=3.37; 95% CI: 1.89-6.00), chemotherapy as 1st treatment (OR=2.05; 95% CI: 1.04-4.03), and late stage (OR=11.14; 95% CI: 1.41-88.06). Conclusion: Delay on treatment initiation seems not influence 3- and 5-years survival rates in the studied population. However, after adjusted by age, stage, and treatment, delays on treatment initiation affected negatively the death risk in 3 years. On the other hand, 5-years death risk was independently associated with age ≥ 70 years, chemotherapy as 1st treatment, and late stage.

scholarly journals Late-Stage Diagnosis of Breast Cancer in Brazil: Analysis of Data from Hospital-Based Cancer Registries (2000–2012)

2018 ◽  
Vol 40 (03) ◽  
pp. 127-136 ◽  
Author(s):  
Nelson Renna Junior ◽  
Gulnar Silva
Keyword(s):  
Breast Cancer ◽  
Late Stage ◽  
White Women ◽  
Multinomial Logistic Regression ◽  
College Education ◽  
Cancer Registries ◽  
Northern Region ◽  
Stage At Diagnosis ◽  
Annual Percent Change ◽  
Late Stage Diagnosis

Objective To analyze the time trend and the factors regarding the diagnosis of late-stage breast cancer in Brazil from 2000 to 2012. Methods We conducted a retrospective cohort study using data from hospital-based cancer registries. Joinpoint regression was used to analyze the time trends of stage at diagnosis. The risk of late-stage presentation was estimated using multinomial logistic regression. Results A total of 170,757 cases were analyzed. The median time from diagnosis to treatment was of 43 days (range: 0–182 days). The percentage of cases with late-stage diagnosis decreased from 2000 to 2002, with an annual percent change (APC) of -6.6% (95% confidence interval [95%CI]: -7.6–-5.5%); it increased from 2002 until 2009, with an APC of 1.1% (95% CI: 0.9–1.3%), and remained stable up to 2012. Women with college education (compared with illiterate women) had less chance of having a late-stage diagnosis (odds ratio [OR]: 0.32; 95%CI: 0.29–0.35). The odds were greater among brown women (OR: 1.30; 95%CI: 1.21–1.41) and black women (OR: 1.63; 95%CI: 1.47–1.82), compared with white women. The odds were also higher for women treated in facilities located and in the Northern region of Brazil (OR: 1.23; 95%CI: 1.04–1.45) and in the Midwest (OR: 1.61; 95%CI: 1.34–1.94), compared with those treated in the southern region of the country. Age, histological type, and marital status were some of the other factors that were positively related to staging at the diagnosis. Conclusion Access to diagnosis of breast cancer is uneven in Brazil, and women with lower socioeconomic status present a greater probability of having an advanced stage at diagnosis.

Distant metastases after diagnosis: Racial disparities in breast cancer outcomes.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1084-1084
Author(s):  
Julia Blanter ◽  
Ilana Ramer ◽  
Justina Ray ◽  
Emily J. Gallagher ◽  
Nina A. Bickell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Black Women ◽  
Racial Disparities ◽  
Late Stage ◽  
White Women ◽  
Univariate Analysis ◽  
Distant Metastases ◽  
Stage At Diagnosis

1084 Background: Black women diagnosed with breast cancer are more likely to have a poor prognosis, regardless of breast cancer subtype. Despite having a lower incidence rate of breast cancer when compared to white women, black women have the highest breast cancer death rate of all racial and ethnic groups, a characteristic often attributed to late stage at diagnosis. Distant metastases are considered the leading cause of death from breast cancer. We performed a follow up study of women with breast cancer in the Mount Sinai Health System (MSHS) to determine differences in distant metastases rates among black versus white women. Methods: Women were initially recruited as part of an NIH funded cross-sectional study from 2013-2020 to examine the link between insulin resistance (IR) and breast cancer prognosis. Women self-identified as black or white race. Data was collected via retrospective analysis of electronic medical records (EMR) between September 2020-January 2021. Distant metastases at diagnosis was defined as evidence of metastases in a secondary organ (not lymph node). Stage at diagnosis was recorded for all patients. Distant metastases after diagnosis was defined as evidence of metastases at any time after initiation of treatment. Univariate analysis was performed using Fisher’s exact test, multivariate analysis was performed by binary logistic regression, and results expressed as odds ratio (OR) and 95% confidence interval (CI). A p value <0.05 was considered statistically significant. Results: We identified 441 women enrolled in the IR study within the MSHS (340 white women, 101 black women). Median follow up time for all women was 2.95 years (median = 3.12 years for white and 2.51 years for black women (p=0.017)). Among these patients, 11 developed distant metastases after diagnosis: 4 (1.2%) white and 7 (6.9%) black (p=0.004). Multivariate analysis adjusting for age, race and stage at diagnosis revealed that black women were more likely to have distant metastasis (OR 5.8, CI 1.3-25.2), as were younger women (OR for age (years) 0.9, CI 0.9-1.0), and those with more advanced stage at diagnosis. Conclusions: Black women demonstrated a far higher percentage of distant metastases after diagnosis even when accounting for age and stage. These findings suggest that racial disparities still exist in the development of distant metastases, independent from a late-stage diagnosis. The source of existing disparities needs to be further understood and may be found in surveillance, treatment differences, or follow up.

scholarly journals The Incidence of Breast Cancer among Disabled Kansans with Medicare

2015 ◽  
Vol 8 (3) ◽  
pp. 93-100
Author(s):  
Austin R Rogers ◽  
Sue-Min Lai ◽  
John Keighley ◽  
Jessica Jungk
Keyword(s):  
Breast Cancer ◽  
Cancer Incidence ◽  
Late Stage ◽  
Breast Cancer Incidence ◽  
Stage At Diagnosis ◽  
Medicare Beneficiaries ◽  
Cancer Registry Data ◽  
Significant Difference ◽  
Disability Status ◽  
Adjusted Incidence

BACKGROUND: Breast cancer disparities by disability status are poorly understood. While previous studies have shown increased odds of late stage at diagnosis, it is unclear whether the incidence of breast cancer varies by disability status. METHODS: To assess cancer incidence and stage at diagnosis among disabled and nondisabled Medicare beneficiaries in Kansas, a retrospective cohort study was conducted using linked Medicare enrollment and Kansas Cancer Registry data from 2007 to 2009. Disability status was determined by the indicator for the original reason for Medicare eligibility. RESULTS: Among the 651,337 Medicare beneficiaries included in the cohort, there were 2,384 cases of breast cancer. The age-adjusted incidence was 313 per 100,000 among female beneficiaries with disabilities and 369 per 100,000 among nondisabled female beneficiaries. The adjusted incidence rate ratio was 0.93 (95% CI 0.73-1.18). When assessing stage at diagnosis, there was no difference in the odds of late stage at diagnosis by disability status (OR = 1.02; 95% CI 0.68-1.50). CONCLUSION: No significant difference in incidence or stage at diagnosis was identified among this cohort. The use of Medicare eligibility to define disability status presented a number of limitations. Future studies should seek alternate definitions of disability to assess disparities in breast cancer incidence, including definitions using Medicare claims data.

scholarly journals Presentation of breast cancer, help seeking behaviour and experience of patients in their cancer journey in Singapore: a qualitative study

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Celene W. Q. Ng ◽  
Jennifer N. W. Lim ◽  
Jenny Liu ◽  
Mikael Hartman
Keyword(s):  
Breast Cancer ◽  
Help Seeking ◽  
Financial Burden ◽  
Support Network ◽  
Medical Attention ◽  
Time Interval ◽  
Delayed Presentation ◽  
Cancer Symptoms ◽  
Qualitative Interview Study ◽  
Help Seeking Behaviour

Abstract Background Little is known about the presentation, help seeking behaviour for breast cancer in Singapore. Nor was there a study exploring the experience of patients in their breast cancer journey. Methods A qualitative interview study with thematic analysis, conducted with 36 patients. Results There is no clear pattern of presentation for breast cancer by cancer stage at diagnosis, age and ethnicity in the cancer journey of this group of patients. Patients were diagnosed with early to advanced stages cancer regardless of when they presented or took up treatment in their cancer journey. The reasons patients sought medical attention also did not appear to differ between the stages of cancer diagnosed, ethnic and age. Without setting a measure to define early and late presentation, we found that women shared similar experience in their breast cancer journey, regardless of age, ethnicity and stage of cancer at diagnosis. Poor knowledge of breast cancer (symptoms and causes); few practised regular BSE; denial of symptom; fear of hospitalisation, diagnosis and treatment; worries and stress over financial burden of treatment; misinformation in magazine and online sources; diet; stress; caring responsibility; support network; and use of alternative medicine before and after diagnosis were identified in patients’ narratives. Strong social support; fear of being an emotional and financial burden for the family; and financial worries during treatment were also the recurring themes after diagnosis. Conclusion A measure of breast cancer presentation - that accounts for the patient’s experience in the cancer journey, the time interval and tumour biology – that is meaningful to patients, clinicians and researchers is needed. For research on late and delayed presentation, details on BSE practice – how often, when and was it done correctly – will improve the accuracy of time delay interval. For the public, concerted efforts to improve knowledge of breast cancer, survival and prognosis for early-diagnosed cancer, and the importance of regular and correct technique to perform BSE, are critical and urgent to address the rising breast cancer incidence in the country.

The impact of COVID-19 on breast cancer stage at diagnosis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 528-528
Author(s):  
Maxwell Roger Lloyd ◽  
Sarah Jo Stephens ◽  
Julian C. Hong ◽  
Ted A. James ◽  
Tejas Mehta ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Late Stage ◽  
The United States ◽  
Stage At Diagnosis ◽  
Lower Income ◽  
Control Cohort ◽  
Stage Disease ◽  
Late Stage Disease ◽  
The Impact

528 Background: During the SARS-CoV-2 pandemic, routine screening mammography (SM) was stopped and diagnostic mammography (DM) was limited for several months across the United States in order to reduce patient exposure and redeploy medical personnel. We hypothesized that this delay would result in patients presenting with later-stage disease following the initial shutdown. Methods: Patients diagnosed with invasive breast cancers from 2016-2020 were identified using the Beth Israel Deaconess Medical Center Cancer Registry. Baseline patient characteristics, demographics, and clinical information were gathered and cross-referenced with our electronic medical record. Late-stage disease was defined as initial anatomic stage III-IV disease in the AJCC 8th edition staging system. The control cohort consisted of patients diagnosed from 2016-2019; patients diagnosed in 2020 were the test cohort. Chi-squared analysis was used to compare monthly distributions in stage at diagnosis between the control and test cohorts. Multivariate analysis was performed using a logistic regression model. Results: There were 1597 patients diagnosed with invasive breast cancer between 2016-2019 and 333 in 2020. Median age at diagnosis was 60 years; 99% were female, and 69.1% were white. Mammography was limited from 3/16/20-6/8/20, with 90% reduction in volume during this time. The number of screening studies performed in March, April, May, and June of 2020 were 987, 1, 4, and 721 compared to 2042, 2141, 2241, and 2142 in 2019. The volume of new diagnoses per month decreased substantially during the shutdown (see table). The proportion of patients diagnosed with late-stage disease was 6.6% in the control cohort compared to 12.6% in the 2020 test cohort (p < 0.001); 92.9% of late-stage diagnoses in 2020 occurred from June to December following the shutdown period. On multivariate analysis, year of diagnosis (2020 vs 2016-2019; OR = 4.25 95% CI 0.035-0.095, p < 0.001), lower income (<200% of the federal poverty level; OR = 2.73 95% CI 0.016-0.099, p = 0.006) and increased Charlson Comorbidity Index (OR = 12.01 95% CI 0.037-0.052, p < 0.001) were associated with later stage at diagnosis. Conclusions: Patients were more likely to be diagnosed with late-stage breast cancer following the global shutdown due to the SARS-CoV-2 pandemic. Patients with lower income and medical comorbidities were disproportionately affected. These data raise significant concerns regarding the impact of SARS-CoV-2 on cancer diagnoses and long-term outcomes, especially in vulnerable patient populations.[Table: see text]

Disparities in advanced-stage breast cancer: The socioeconomic and geographic contributions.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 134-134
Author(s):  
Kelli Clemons ◽  
William Forehand ◽  
Hongyan Xu ◽  
Li Fang Zhang ◽  
Priyanka Raval
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Late Stage ◽  
Early Stage ◽  
Private Insurance ◽  
Clinical Stage ◽  
Metastatic Breast ◽  
Cancer Center ◽  
P Value ◽  
Time Interval

134 Background: Socioeconomic disparities in healthcare have been well documented in America, with cancer being a critical area. One in four deaths are caused by cancer, and the effects on different communities are not equal. Clinical observations suggest that poorer socioeconomic circumstances lead to more frequent, later stage diagnoses and worse outcomes. The aim of this project was to quantify the sociodemographic and geographic contributions to disparities in advanced, metastatic breast cancer within the Augusta population and surrounding areas. Methods: Records of patients managed for breast cancer at the Georgia Cancer Center between Jan 2009- Jun 2019 were reviewed. 80 patients who presented with early stage breast cancer (clinical stage I) without positive lymph nodes were compared with 80 patients who presented with advanced, metastatic disease (clinical stage III-IV). Their race, breast cancer characteristics, insurance status, geographic proximity to a mammography site or major healthcare facility, and time interval between diagnosis and treatment were compared. Results: Results show that 73.75% early stage patients had private insurance, while 41.25% late stage patients had private insurance (p value < 0.0001). Results also show that 25.0% of late stage patients had annual mammography screenings, while 77.78% of early stage patients had regular screening for mammograms (p value < 0.0001). 80.6% of patients that received regular mammograms had private insurance, while the remaining 19.4% of those patients had public insurance. No statistical difference was shown in late and early stage presentation based on HER2 and/or triple negative (ER-, PR-, HER2-) status. Conclusions: There is a significant outcome of advanced, metastatic breast cancer in patients that do not have private insurance and in those that do not receive regular mammograms. Our findings support the importance of investing resources into alleviating differences in various socioeconomic populations as they relate to the amount and quality of cancer healthcare available. While the incidence of mortality in breast cancer is decreasing nationwide, disparities in morbidity and mortality will most likely continue unless there is an aggressive effort towards addressing said differences.

Disparities in advanced stage breast cancer: The socioeconomic and geographic contributions.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19055-e19055
Author(s):  
Kelli Clemons ◽  
William Forehand ◽  
Hongyan Xu ◽  
Li Fang Zhang ◽  
Priyanka Raval
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Late Stage ◽  
Early Stage ◽  
Private Insurance ◽  
Clinical Stage ◽  
Metastatic Breast ◽  
P Value ◽  
Time Interval ◽  
Regular Screening

e19055 Background: Socioeconomic disparities in healthcare have been well documented in America, with cancer being a critical area. One in four deaths are caused by cancer, and the effects on different communities are not equal. Clinical observations suggest that poorer socioeconomic circumstances lead to more frequent, later stage diagnoses and worse outcomes. The aim of this project was to quantify the sociodemographic and geographic contributions to disparities in advanced, metastatic breast cancer within the Augusta population and surrounding areas. Methods: Records of patients managed for breast cancer at the Georgia Cancer Center between Jan 2009- Jun 2019 were reviewed. 80 patients who presented with early stage breast cancer (clinical stage I) without positive lymph nodes were compared with 80 patients who presented with advanced, metastatic disease (clinical stage III-IV). Their race, breast cancer characteristics, insurance status, geographic proximity to a mammography site or major healthcare facility, and time interval between diagnosis and treatment were compared. Results: Results show that 73.75% early stage patients had private insurance, while 41.25% late stage patients had private insurance (p value < 0.0001). The early stage patients were 4.0 times more likely to have private insurance than late stage patients. Results also show that 25.0% of late stage patients had annual mammography screenings, while 77.78% of early stage patients had regular screening for mammograms (p value < 0.0001). The late stage patients were 1/10 as likely to have regular screening for mammogram as early stage patients. 80.6% of patients that received regular mammograms had private insurance, while the remaining 19.4% of those patients had public insurance. No statistical difference was shown in late and early stage presentation based on HER2 and/or triple negative (ER-, PR-, HER2-) status. Conclusions: There is a significant outcome of advanced, metastatic breast cancer in patients that do not have private insurance and in those that do not receive regular mammograms. Our findings support the importance of investing resources into alleviating differences in various socioeconomic populations as they relate to the amount and quality of cancer healthcare available. While the incidence of mortality in breast cancer is decreasing nationwide, disparities in morbidity and mortality will most likely continue unless there is an aggressive effort towards addressing said differences.

scholarly journals Drivers of Disparities in Stage at Diagnosis Among Women With Breast Cancer: South African Breast Cancers and HIV Outcomes Cohort

2022 ◽  
Author(s):  
Witness Mapanga ◽  
Shane A Norris ◽  
Ashleigh Craig ◽  
Oluwatosin A. Ayeni ◽  
Wenlong C. Chen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health System ◽  
South African ◽  
Late Stage ◽  
System Level ◽  
Receptor Subtypes ◽  
Stage At Diagnosis ◽  
Breast Cancers ◽  
Luminal B ◽  
Individual Level

Abstract Objective In low- and middle-income countries (LMICs), advanced stage diagnosis of breast cancer (BC) is common, and this contributes to poor survival. By understanding the determinants of the stage at diagnosis will aid in designing interventions to downstage disease and improve survival from BC in LMICs. MethodsWithin the South African Breast Cancers and HIV Outcomes (SABCHO) cohort, we examined factors affecting the stage at diagnosis of histologically confirmed invasive breast cancer at five tertiary hospitals in South Africa. The stage was assessed clinically. To examine the associations of the health system, socio-economic/household and individual factors, hierarchical multivariate logistic regression with odds of late-stage at diagnosis (stage III-IV), was used. Results The majority (59%) of the included 3497 women were diagnosed with late-stage BC disease (59%). The effect of health system-level factors on late-stage BC diagnosis was consistent and significant even when adjusted for both socio-economic- and individual-level factors. Women diagnosed in a tertiary hospital that predominantly serves a rural population were almost 3 times (OR=2.89 (95% CI: 1.40-5.97) likely to be associated with late-stage BC diagnosis when compared to those diagnosed at a hospital that predominantly serves an urban population. Taking more than 3 months from identifying the BC problem to first health system entry (OR=1.66 (95% CI: 1.38–2.00)), and receptor subtypes [luminal B (OR=1.49 (95% CI: 1.19–1.87)), HER2 enriched (OR=1.64 (95% CI: 1.16–2.32))] were associated with a late-stage diagnosis. Whilst having a higher socio-economic level (a wealth index of 5) reduced the probability of late-stage BC, OR=0.64 (95% CI: 0.47 – 0.85). ConclusionAdvanced stage diagnosis of BC among women in SA who access health services through the public health system was associated with both modifiable health system-level factors and non-modifiable individual-level factors. These may be considered as elements in interventions to reduce the time to diagnosis of breast cancer in women.

Sign in / Sign up

Export Citation Format

Share Document